Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 13;13(3):e0193729.
doi: 10.1371/journal.pone.0193729. eCollection 2018.

Excess mortality and hospitalizations in transitional-age youths with a long-term disease: A national population-based cohort study

Antoine Rachas  1   2   3 , Philippe Tuppin  4 , Laurence Meyer  1   2   3 , Bruno Falissard  1   2   3 , Albert Faye  5   6   7 , Nizar Mahlaoui  8   9   10   11 , Elise de La Rochebrochard  1   12 , Marie Frank  13 , Pierre Durieux  11   14   15 , Josiane Warszawski  1   2   3
Affiliations

Excess mortality and hospitalizations in transitional-age youths with a long-term disease: A national population-based cohort study

Antoine Rachas et al. PLoS One. .

Erratum in

Abstract

Introduction: The number of adolescents with a severe chronic disease has increased in high-income countries due to improvements in the prognosis of childhood-onset chronic conditions. The transition from childhood to adulthood is a critical period that may be associated with increased mortality and morbidity. We aimed to estimate the prevalence of adolescents with a long-term disease (LTD) in France and assess their mortality and hospitalization risks relative to the general population.

Materials and methods: We extracted a population-based cohort from the French national health insurance database that included 61,119 subjects who reached 14 years of age between 2005 and 2014. LTDs are diagnosed by patients' physicians and then confirmed and registered by a physician of the national health insurance system. We assessed mortality and hospitalizations using data of patients who were between 14 and 21 years-old.

Results: Among 14-year-old adolescents, 3.30% (95% confidence interval: 3.16-3.44) had a LTD. Their mortality rate between the ages of 14 and 21 years was 20.9/10,000 person-years (13.7-32.1) versus 1.9 (1.5-2.5) for adolescents without a LTD. Mortality was higher in males than females in youths without a LTD, but not in those with a LTD. We found a similar pattern for the risk of hospitalization for an external cause. The five-year probability of hospitalization was 61.8% among youths with a LTD versus 42.7% for those without. The rate of planned hospitalizations sharply fell at 19 years-of-age among youths with a LTD, whereas the rate of unplanned hospitalizations remained stable.

Conclusion: The 3% of youths with a LTD have ten-fold higher mortality than those without and a high risk of hospitalization. The decrease in the rate of planned hospitalizations at age 19 among youths with a LTD may indicate differences in medical practice after transfer to adult care or a break in medical care.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Probability of hospitalizations in short-stay units by gender and long-term disease status between the ages of 14 and 21 years (N = 61,119).
Fig 2
Fig 2. Evolution of the incidence of hospitalization in short-stay units between 14 and 21 years of age (N = 61,119).
See this image and copyright information in PMC

References

    1. UK CF Registry. Annual Data Report 2008. Cystic Fibrosis Trust; 2009.
    1. Burgel P-R, Bellis G, Olesen HV, Viviani L, Zolin A, Blasi F, et al. Future trends in cystic fibrosis demography in 34 European countries. Eur Respir J. 2015;46: 133–141. doi: 10.1183/09031936.00196314 - DOI - PubMed
    1. Moons P, Bovijn L, Budts W, Belmans A, Gewillig M. Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation. 2010;122: 2264–2272. doi: 10.1161/CIRCULATIONAHA.110.946343 - DOI - PubMed
    1. Quinn CT, Rogers ZR, McCavit TL, Buchanan GR. Improved survival of children and adolescents with sickle cell disease. Blood. 2010;115: 3447–3452. doi: 10.1182/blood-2009-07-233700 - DOI - PMC - PubMed
    1. Hazra R, Siberry GK, Mofenson LM. Growing up with HIV: children, adolescents, and young adults with perinatally acquired HIV infection. Annu Rev Med. 2010;61: 169–185. doi: 10.1146/annurev.med.050108.151127 - DOI - PubMed